Auditory stimulus for auditory rehabilitation

ABSTRACT

Generally, a method performed by one or more processing devices includes generating a graphical user interface that when rendered on a display of the one or more processing devices renders a visual representation of an environment and a visual representation of an object in the environment; retrieving an auditory stimulus with one or more auditory attributes indicative of a location of a virtual target in the environment; receiving information specifying movement of the object in the environment; determining, based on the movement of the object, a proximity of the object to the virtual target; adjusting, based on the proximity, one or more values of the one or more auditory attributes of the auditory stimulus; and causing the one or more processing devices to play the auditory stimulus using the adjusted one or more values.

RELATED APPLICATIONS

This application is a 371 U.S. National of PCT/US2012/043707, filed Jun.22, 2012, which claims priority under 35 U.S.C. §119(e) to provisionalU.S. Patent Application 61/499,871, filed on Jun. 22, 2011, the entirecontents of each of which are hereby incorporated by reference.

BACKGROUND

A cochlear implant is a surgically implanted electronic device thatprovides a sense of sound to an individual who is deaf and/or hard ofhearing. In an example, an effectiveness of a cochlear implant increaseswhen the recipient of the cochlear implant receives auditoryrehabilitation, e.g., relative to the effectiveness of the cochlearimplant when the recipient does not receive auditory rehabilitation.Generally, auditory rehabilitation includes programs and/or activitiesthat promote understanding of auditory signals, including, e.g., sounds,music, speech, and so forth.

In an example, auditory rehabilitation includes training an individualto recognize acoustic cues during communication. That is, the acousticsignal may be received, but phonetic and syntactic information must beextracted for the sound to have meaning to an individual. In thisexample, auditory rehabilitation trains an individual to listen forrhythm, inflection, intonation, and accent in speech communication.Auditory rehabilitation also trains an individual to recognizecontextual cues in communication, including, e.g., whether the lips ofan individual speaking are pursed or spread apart. Auditoryrehabilitation may also train an individual in vowel recognition, asvowels may be the strongest voiced elements of speech.

SUMMARY

In one aspect of the present disclosure, a method performed by one ormore processing devices includes generating a graphical user interfacethat when rendered on a display of the one or more processing devicesrenders a visual representation of an environment and a visualrepresentation of an object in the environment; retrieving an auditorystimulus with one or more auditory attributes indicative of a locationof a virtual target in the environment; receiving information specifyingmovement of the object in the environment; determining, based on themovement of the object, a proximity of the object to the virtual target;adjusting, based on the proximity, one or more values of the one or moreauditory attributes of the auditory stimulus; and causing the one ormore processing devices to play the auditory stimulus using the adjustedone or more values.

Implementations of the disclosure may include one or more of thefollowing features. In some implementations, the method also includesdetecting, following play of the auditory stimulus, that a location ofthe object in the environment corresponds to the location of the virtualtarget in the environment. In other implementations, the actions ofreceiving, determining, and adjusting are repeated until a location ofthe object in the environment corresponds to the location of the virtualtarget in the environment.

In still other implementations, the method includes causing a diagnosticauditory signal to be played on the one or more processing devices;receiving information indicative of a response of a user to thediagnostic auditory signal; determining, at least partly based on thereceived information, auditory dysfunction in one or more types ofauditory perception of the user; generating, based on the determinedauditory dysfunction, the one or more auditory attributes; anddetermining, based on one or more amounts of auditory dysfunction in theone or more types of auditory perception, one or more ranges of valuesfor the one or more auditory attributes.

In some implementations, the one or more ranges of values include one ormore ranges of first values, and the method further includes: detectinga decrease in auditory dysfunction of the user; and updating, based onthe detected decrease, the first values to second values, with thesecond values promoting an additional decrease in auditory dysfunctionof the user. The method may also include determining, based on theproximity, that the object has moved towards the virtual target; andgenerating, based on adjusting of the one or more values of the one ormore auditory attributes, a notification that the object has movedtowards the virtual target.

In other implementations, the method includes determining, based on theproximity, that the object has moved away from the virtual target; andgenerating, based on adjusting of the one or more values of the one ormore auditory attributes, a notification that the object has moved awayfrom the virtual target. In still other implementations, the auditorystimulus promotes auditory rehabilitation in a user of the one or moreprocessing devices by training the user to locate the virtual target inthe environment based on a perception of the user of the one or moreauditory attributes.

In another aspect of the disclosure, one or more machine-readable mediaare configured to store instructions that are executable by one or moreprocessing devices to perform operations including generating agraphical user interface that when rendered on a display of the one ormore processing devices renders a visual representation of anenvironment and a visual representation of an object in the environment;retrieving an auditory stimulus with one or more auditory attributesindicative of a location of a virtual target in the environment;receiving information specifying movement of the object in theenvironment; determining, based on the movement of the object, aproximity of the object to the virtual target; adjusting, based on theproximity, one or more values of the one or more auditory attributes ofthe auditory stimulus; and causing the one or more processing devices toplay the auditory stimulus using the adjusted one or more values.Implementations of this aspect of the present disclosure may include oneor more of the foregoing features.

In still another aspect of the disclosure, an electronic system includesone or more processing devices; and one or more machine-readable mediaconfigured to store instructions that are executable by the one or moreprocessing devices to perform operations including: generating agraphical user interface that when rendered on a display of the one ormore processing devices renders a visual representation of anenvironment and a visual representation of an object in the environment;retrieving an auditory stimulus with one or more auditory attributesindicative of a location of a virtual target in the environment;receiving information specifying movement of the object in theenvironment; determining, based on the movement of the object, aproximity of the object to the virtual target; adjusting, based on theproximity, one or more values of the one or more auditory attributes ofthe auditory stimulus; and causing the one or more processing devices toplay the auditory stimulus using the adjusted one or more values.Implementations of this aspect of the present disclosure may include oneor more of the foregoing features.

All or part of the foregoing may be implemented as a computer programproduct including instructions that are stored on one or morenon-transitory machine-readable storage media, and that are executableon one or more processing devices. All or part of the foregoing may beimplemented as an apparatus, method, or electronic system that mayinclude one or more processing devices and memory to store executableinstructions to implement the stated functions.

The details of one or more implementations are set forth in theaccompanying drawings and the description below. Other features,objects, and advantages will be apparent from the description anddrawings, and from the claims.

BRIEF DESCRIPTION OF THE FIGURES

FIG. 1A shows an example system for promotion of auditoryrehabilitation.

FIGS. 1B-1E show examples of a distributed targets for promotion ofauditory rehabilitation.

FIG. 2 is a block diagram of the example system for promotion ofauditory rehabilitation.

FIG. 3 is a flow diagram of an exemplary process for diagnosing types ofauditory dysfunction.

FIG. 4 is a flow diagram of an exemplary process for promotion ofauditory rehabilitation.

DETAILED DESCRIPTION

Described herein is a system and method for promotion of auditoryrehabilitation in individuals experiencing auditory dysfunction (e.g.,hearing loss, tinnitus, deafness, and so forth) and/or in individualsusing cochlear implants. In an example, individuals may experienceauditory dysfunction due to maladaptive plasticity in the individual'sneural system (e.g., brain). Generally, neural plasticity includes acapacity of the central nervous system to change its structure,chemistry, and physiology according to an individual's specificexperiences. The system promotes auditory rehabilitation by promotingadaptive plasticity of brain circuits involved with sound processing inindividuals experiencing auditory dysfunction, e.g., relative to theneural plasticity of individuals not receiving auditory rehabilitation.

The system increases the neural plasticity of an individual throughimplementation of an auditory rehabilitation feedback loop, in which thesystem provides the individual with auditory stimuli, collects theindividual's response to the auditory stimuli, and uses the response torapidly generate additional auditory stimuli to maximize learning andthe underlying expression of brain plasticity in the individual.Generally, an auditory stimulus is includes as acoustic event in anenvironment that changes electrical activity levels of neurons locatedin auditory pathways of the brain. By engaging auditory learning inindividual experiencing auditory dysfunction, the system allows theindividual to more rapidly and accurately recognize auditory stimuli,which improves the hearing of the individual.

In an example, the system efficiently engages therapeutic brainplasticity mechanisms in an individual through implementation of aclosed-loop auditory rehabilitation system, in which the auditorystimuli are modified according to the individual's virtual movementpatterns in real time. In this example, the individual's decisions aboutvariations in auditory stimuli, as expressed through movement patterns,are nearly instantaneously translated into auditory feedback, which, inturn, can be used to refine subsequent and ongoing auditory-baseddecisions. Closed-loop approaches increase the efficiency ofneurological mechanisms underlying motor and sensory skill learning. Byengaging auditory learning in individuals experiencing auditorydysfunction, the system improves the neurological representation of theauditory stimulus, which translates to an improvement in the sensitivityand acuity of hearing in the individual.

In another example, the system includes a portable system that may beused by an individual in a home, an office, a restaurant, a shop, and/orany other location in which the individual may desire to use theportable system. In an example, a portable system may include a systemweighing less than ten pounds. Additionally, due to the portable natureof the system, the system includes a portable diagnostic graphical userinterface for diagnosis of auditory dysfunction in individuals. Thesystem also includes a portable training graphical user interface thatpromotes auditory rehabilitation.

In the below examples, techniques are described for treating auditorydysfunction (e.g., hearing loss, tinnitus, deafness, and so forth) inindividuals and/or in individuals using cochlear implants. Generally,tinnitus is the perception of noises in the ear which correspond to noacoustic signal in the environment. In an example, the describedtechniques treat auditory dysfunction by a closed-loop auditory trainingtask, in which the user receives auditory feedback that is linked inreal time to sound-guided motor behavior. The closed-loop auditorytraining task promotes the following events, e.g., (i) the corticalexcitatory/inhibitory dysregulation that causes the tinnitus percept isdeceased (and/or eliminated) through a brain plasticity-based treatmentthat does not involve exogenous agents or surgery; (ii) perception ofthe signal (e.g., acoustic inputs transduced by viable regions of thecochlea) are accentuated, (iii) perception of noise (i.e., phantomsound) is attenuated, and (iv) “top-down” modulation of low-levelauditory cortical areas (e.g., by involving working memory andpredictive systems) is enhanced.

FIG. 1A shows an example system 100 for promotion of auditoryrehabilitation. In the illustrative example of FIG. 1A, system 100includes computing device 102. Computing device 102 can be a personaldigital assistant, a personal computer, a laptop, a server, a cellphone, a mobile computing device, a media-player-type device, asmartphone, a tablet device, a portable computing device, a video gameconsole, and so forth. Computing device 102 is configured forcommunication with input device 136, including, e.g., a mouse, a videogame controller, and so forth. Input device 136 allows user 138 to inputinto computing device 102 information, including, e.g., textinformation, movement information (e.g., information indicative ofmovement of user 138 in the physical world), and so forth.

Computing device 102 is also configured for communication withheadphones 137, e.g., for the playing of auditory signals generated bycomputing device 102. In an example, headphones 137 include a microphonefor the input of voice information into computing device 102. Computingdevice 102 also includes display 108 for the rendering of images andgraphical user interfaces, including, e.g., training graphical userinterfaces (e.g., graphical user interfaces 106, 114) and diagnosticgraphical user interfaces, as described in further detail below.

In a variation of FIG. 1A, computing device 102 may include speakers(not shown) (e.g., rather than headphones 137 or in addition toheadphones 137). In this example, computing device 102 may have a wiredand/or a wireless connection with the speakers. As described in furtherdetail below, the speakers may also be used in conjunction withdiagnostic module 131 to test the heading of user 138.

In the illustrative example of FIG. 1A, user 138 is an individual withauditory dysfunction. In this example, computing device 102 isconfigured to run an application 104, which promotes auditoryrehabilitation in user 138, as described in further detail below. In anexample, application 104 includes a video game, an auditory game, asmartphone application, and so forth. System 100 also includes network139, including, e.g., a wireless network, the Internet, or other typesof networks. System 100 also includes application provider device 140,including, e.g., a server or other computing device. In this example,application provider device 140 is configured to store application 104.Computing device 102 accesses network 139 to download application 104from application provider device 140.

In this example, application 104 promotes auditory rehabilitation inuser 138 by mapping properties of an auditory signal onto a visualspace, including, e.g., a two-dimensional visual space, athree-dimensional visual space, and forth. Generally, a property of anauditory signal includes a characteristic of an auditory signal that maybe detected by user 138. In an example, properties of an auditory signalinclude spectral characteristics, temporal characteristics,signal-to-noise characteristics, binaural characteristics, and/or anycombination thereof (e.g., pitch, tempo, timbre, rhythm, porosity,volume, modulation of a sound envelope, and so forth).

In the illustrative example of FIG. 1A, application 104 generatesrehabilitation program 107 as the visual space. In this example,rehabilitation program 107 includes a visual representation of anenvironment, including, e.g., a virtual world, a gaming world, and soforth. Rehabilitation program 107 includes graphical user interfaces106, 114 for the display of a visual representation of an object andvirtual target 118 to be located by the visual representation of theobject. In the illustrative example of FIG. 1A, the object includesavatar 110. A goal of rehabilitation program 107 is for avatar 110,which is controlled by user 138 via input device 136, to locate virtualtarget 118, which is hidden in graphical user interface 106 when user138 beings playing rehabilitation program 107.

Application 104 also generates auditory stimulus 132. Generally,auditory stimuli may include one or more auditory attributes. Generally,an auditory attribute includes a property of an auditory signal. In anexample, an auditory attribute includes an acoustic cue that providesuser 138 with feedback about a proximity of avatar 110 in graphical userinterface 106 relative to virtual target 118. In this example, theacoustic cue provides user 138 with the feedback (e.g., real-timefeedback) based on the properties of the acoustic cue. Auditory stimulus132 is mapped onto rehabilitation program 107 by changing the acousticcues of auditory stimulus 132 during game play, e.g., during real-timegame place.

In an example, application 104 may generate dynamic acoustic cues (e.g.,in real-time) by modifying the basic properties of an auditory signal,which may include spectral characteristics, temporal characteristics,signal-to-noise characteristics, binaural characteristics, and/or anycombination thereof (e.g., pitch, tempo, timbre, rhythm, porosity,volume, modulation of a sound envelope, and so forth). In this example,the pitch of auditory stimulus 132 provides a real-time acoustic cue touser 138 regarding the location of virtual target 118 in graphical userinterface 106. As avatar 110 moves towards virtual target 118, the pitchof auditory stimulus 132 adjusts (e.g., increases) in real-time toprovide user 138 with an acoustic cue that user 138 has moved avatar 110towards virtual target 118. Many of the below examples use pitch as thetype of acoustic cue. However, the below examples are equally applicableto other types of acoustic cues, which may include acoustic cues basedon modifications to spectral characteristics, temporal characteristics,signal-to-noise characteristics, binaural characteristics, and/or anycombination thereof (e.g., pitch, tempo, timbre, rhythm, porosity,volume, modulation of a sound envelope, and so forth).

In the illustrative example of FIG. 1A, graphical user interface 106 isrendered on display 108 when user 138 begins playing rehabilitationprogram 107 at a first point in time, namely, “T1.” Graphical userinterface 106 includes visual representation 112 of textual informationinstructing user 138 to move avatar 110 to find virtual target 118.Graphical user interface 114 is rendered on display 108 when avatar 110finds virtual target 118 at a second point in time subsequent to thefirst point in time, namely, “T2.” In this example, graphical userinterface 114 also includes visual representation 116 of textualinformation congratulating user 138 on finding virtual target 118.

In an example, as user 138 moves avatar 110 via input device 136,computing device 102 generates response information 134, including,e.g., information indicative of a location of avatar 110 in graphicaluser interface 106 that is rendered on display 108. Using responseinformation 134, application 104 compares a current location of avatar110 in graphical user interface 106 to virtual target 118 in graphicaluser interface 106. Based on the comparison, application 104 adjusts inreal-time the pitch of auditory stimulus 132 to a level that indicateswhether avatar 110 has moved towards or away from virtual target 118. Inan example, auditory stimulus 132 may include a range of pitches. Asuser 138 moves avatar 110 closer to virtual target 118, the pitch ofauditory stimulus 132 increases in real-time relative to the pitch ofauditory stimulus 132 when user 138 moves avatar 110 away from virtualtarget 118. As user 138 moves avatar 110 away from virtual target 118,application 104 translates the pitch of auditory stimulus 132, e.g.,relative to the pitch of auditory stimulus 132 as user 138 moves avatar110 towards virtual target 118. Application 104 trains user 138 tolocate virtual target 118 by moving avatar 110 in a direction that isconsistent with the target pitch of auditory stimulus 132 that has beenassociated with virtual target 118. By training user 138 to discriminatechanges in the pitch of auditory stimulus 132, application 104 inducesan adaptive plasticity within the central auditory pathways of user 138,which in turn promotes auditory rehabilitation of user 138.

In an example, application 104 continues the foregoing process ofreceiving response information 134 and using the received responseinformation 134 to change the pitch of auditory stimulus 132 inreal-time, until user 138 locates virtual target 118, e.g., by movingavatar 110 to a location in graphical user interface 114 thatcorresponds to the location of virtual target 118. Generally, acorrespondence includes a similarity or relatedness between two items ofinformation. In this example, the combination of auditory stimulus 132and response information 134 form the auditory rehabilitation feedbackloop between application 104 and user 138 to promote an adaptive neuralplasticity of user 138. The auditory rehabilitation feedback loop may bea continuous feedback loop in which application 104 receives responseinformation 134 in real-time and automatically changes the pitch ofauditory stimulus 132, based on response information 134.

The effectiveness of auditory rehabilitation is at least partly based onthe rate and the efficiency of feedback for auditory-based perceptualdecisions. In the illustrative example of FIG. 1A, based on the pitch ofauditory stimulus 132, user 138 makes real-time, auditory-basedperceptual decisions by deciding in which direction to move avatar 110in graphical user interface 106. Based on the direction in which user138 decides to move avatar 110, application 104 changes, in real-time,the pitch of auditory stimulus 132. As previously described, the changein pitch further influences the auditory-based perceptual decisions ofuser 138, e.g., by indicating whether avatar 110 has moved towards oraway from virtual target 118. Because the pitch may be adjusted inreal-time, application 104 is configured to increase the rate and theefficiency of feedback on auditory-based perceptual decision in user138, which promotes accelerated auditory rehabilitation.

In an example, application 104 includes tracking engine 105 to trackmovement of avatar 110 in graphical user interface 106. In theillustrative example of FIG. 1A, tracking engine 105 includes map 130 totrack the movement of avatar 110 in directions 120, 122, 124, 126. Map130 includes a location of virtual target 118 and a location of avatar110. As avatar 110 is moved in graphical user interface 106, trackingengine 105 updates map 130 with the location of avatar 110. In anexample, tracking engine 105 determines the distance between virtualtarget 118 and avatar 110 using the coordinates of virtual target 118 inmap 130, the coordinates of avatar 110 in map 130, and a distanceformula (e.g., the Pythagorean Theorem).

In another example, rehabilitation program 107 operates in a mode whereone acoustic dimension is mapped onto a vertical axis and a seconddimension is mapped onto a horizontal axis. Virtual target 118 reflectstwo acoustic properties and user 138 ‘solves’ both acoustic propertiesin order to identify the location of virtual target 118. In thisexample, a distance between avatar 110 and virtual target 118 iscomputed by tracking engine 105 as the separation along each axis.

In an example, as user 138 moves avatar 110 in direction 126 or indirection 124 towards virtual target 118, application 104 increases thepitch of auditory stimulus 132, e.g., relative to a value of the pitchof auditory stimulus 132 when avatar 110 is moved in direction 120and/or in direction 122 away from virtual target 118. In this example,application 104 determines a value of the pitch of auditory stimulus 132based on a mapping of the distance between virtual target 118 and avatar110 to pitch, as shown in the below Table 1:

TABLE 1 Pitch according to the Distance in fundamental centimeters(“cm”) frequency in Hertz (Hz) 4 cm-3.1 cm 2000 Hz 3 cm-2.1 cm 2828 Hz 2cm-1.1 cm 4000 Hz 1 cm-.1 cm  5657 Hz 0 cm 8000 Hz

As illustrated in the above Table 1, application 104 generates a mappingof pitches for auditory stimulus 132 to a range of distances. In thisexample, the distance between virtual target 118 and avatar 110 mayrange from 4 cm-0 cm. As the distance decreases from 4 cm to 0 cm, thepitch of auditory stimulus 132 increases from 2000 Hz to 8000 Hz. Inthis example, when the location of avatar 110 matches the location ofvirtual target 118, the distance between virtual target 118 and avatar110 is about 0 cm and the pitch is 8000 Hz, which is higher than theother pitches included in the mapping of Table 1.

In another example, application 104 dynamically determines the pitch ofauditory stimulus 132 using a heuristic algorithm that calculates pitchas a function of one or more parameters, as illustrated in the belowTable 2.

TABLE 2 Pitch (Hz) = 8000 − (distance × 4)

As illustrated in the above Table 2, the heuristic algorithm executed byapplication 104 uses values of one or more parameters in calculatingpitch. In this example, the pitch of auditory stimulus 132 is based on avalue for a parameter (“distance parameter”) indicative of the distancebetween virtual target 118 and avatar 110. Application 104 calculates apitch by multiplying the value of the distance parameter by a value offour and subtracting this resultant value from a value of 8000.

Still referring to the illustrative example of FIG. 1A, user 138 beginsplaying rehabilitation program 107 at time T1. In this example, trackingengine 105 uses map 130 to calculate the distance between avatar 110 ingraphical user interface 106 and virtual target 118. Using thecalculated distance, application 104 determines a pitch for auditorystimulus 132, e.g., based on a mapping (e.g., the mapping of Table 1)and/or based on a heuristic algorithm (e.g., the heuristic algorithm ofTable 2). In this example, through headphones 137, user 138 hearsauditory stimulus 132 at the determined pitch.

In a variation of FIG. 1A, application provider device 140 is configuredto store application 104. In this example, computing device 102 accessesover network 139 application 104 from application provider device 140,e.g., rather than downloading application 104 onto computing device 102.In this example, application 104 is deployed over the Internet, vianetwork 139, and is accessible by computing device 102 from applicationprovider device 140.

In another example, application 104 also includes diagnostic module 131that is configured to diagnose the degree and form of auditorydysfunction in user 138 and to generate rehabilitation program 107 thatis specific to user 138 based on the degree and form of auditorydysfunction. In this example, diagnostic module 131 measures an amountof auditory dysfunction in user 138 by analyzing an ability of user 138to detect changes in various properties of an auditory signal generatedby diagnostic module 131 (e.g., a “diagnostic auditory signal”).

As previously described, application 104 adjusts values of an acousticcue (e.g., increasing and/or decreasing pitch) based on a proximity ofavatar 110 to virtual target 118. In an example, an acoustic cue isassociated with a range of values that may be used for the acoustic cue.In this example, diagnostic module 131 is configured to determine therange of values for an acoustic cue. Diagnostic module 131 determinesthe magnitude of values and the span of values in the range for anacoustic cue based on the amount of auditory dysfunction exhibited byuser 138.

For example, when user 138 exhibits a large amount of auditorydysfunction for a particular type of perception, diagnostic module 131may generate an acoustic cue with a larger span of values and a largermagnitude of values to promote an ability of user 138 to perceiveauditory properties associated with the particular type of perception.In another example, when user 138 exhibits a small amount of auditorydysfunction for another type of perception, diagnostic module 131 maygenerate an acoustic cue with a smaller span of values and a smallermagnitude of values to increase an ability of user 138 to perceiveauditory properties associated with the other type of perception. Asdiagnostic module 131 detects an improvement in hearing of user 138(e.g., a decrease in auditory dysfunction), diagnostic module 131 may beconfigured to dynamically change the magnitude and/or the span of thevalues included in the ranges for the acoustic cues. To do so,diagnostic module 131 may also receive response information 134.Diagnostic module 131 may use response information 134 to determinewhether user's hearing has improved and to adjust the range of valuesfor the acoustic cues accordingly, e.g., by compressing the range ofvalues to make detection of the acoustic cues more difficult and thusincreasingly more challenging for user 138.

Diagnostic module 131 measures auditory dysfunction in numerous types ofauditory perception, including, e.g., spectral perception, temporalperception, binaural perception, signal-to-noise perception, and soforth. Generally, spectral perception includes an ability of a user toperceive a pitch of an auditory signal. Temporal perception includes anability of the user to perceive the rate and depth by which the soundpressure envelope is modulated in time. Binaural perception includes anability of a user to perceive differences in the relative timing andlevel of auditory stimuli presented to each ear. Signal-to-noiseperception includes an ability of the user to perceive an auditorysignal among noise, e.g., detecting a tone among babbling speech and/orbackground noise. Using the types of auditory perception with diagnosedauditory dysfunction, diagnostic module 131 generates rehabilitationprogram 107 to train user 138 to better perceive the properties of anauditory signal that are associated with the types of auditoryperception in which user 138 exhibits auditory dysfunction.

In an example, diagnostic module 131 is configured to measure thespectral perception of user 138 based on a behavioral test that usespure-tone thresholds (PTTs) to measure hearing sensitivity. PTTsindicate the softest sound audible to an individual at least 50% of thetime. Diagnostic module 131 generates a plot of measured hearingsensitivity on an audiogram, which is a graph displaying intensity as afunction of frequency.

In an example, diagnostic module 131 has two training modes. In thefirst training mode, the target sound is remembered by user 138 and user138 adjusts the sound being heard until user 138 believes the soundbeing heard matches the target sound user 138 has recalled from memory,as described above. In the second training mode, the target sound isplayed into one headphone continuously. User 138 moves avatar 110, whichchanges the sound in the training ear, until the sounds in the trainingear matches the target sound user 138 hears in the other ear. Thus,virtual target 118 is the position where the inputs from each ear areequivalent.

In this example, diagnostic module 131 generates a diagnostic graphicaluser interface (not shown) that when rendered on display 108 renders avisual representation of instructions for user 138 to follow. Theinstructions specify that user 138 should perform an action when theuser 138 perceives a sound. In this example, the action may includeselecting a button on input device 136 and/or speaking a pre-definedword (e.g., “sound!”).

Based on the softest sound audible to user 138 at least 50% of the time,diagnostic module 131 generates an “audiogram” indicative of thethreshold sensitivity across the hearing range of user 138. In thisexample, diagnostic module 131 analyzes the audiogram to determinewhether user 138 exhibits dysfunction in specific frequency ranges. Ifdiagnostic module 131 determines that user 138 exhibits auditorydysfunction in particular frequency ranges, diagnostic module 131configures rehabilitation program 107 to train user 138 to discriminatepitch changes within the least sensitive frequency ranges previouslyidentified by diagnostic module 131.

In another example, diagnostic module 131 is configured to measure thetemporal perception of user 138. In this example, diagnostic module 131instructs user 138 to perform an action when user 138 detects a changein rate of an auditory signal generated by diagnostic module 131. Basedon the ability of user 138 to correctly perceive changes in rate of theauditory signal, diagnostic module 131 generates temporal informationindicative of a strength of the temporal perception of user 138.

In still another example, diagnostic module 131 measures temporalperception of user 138 based on envelope modulation discriminationlimens, in which user 138 is presented a sequence of two sinusoidallyamplitude modulated monaural tones with variable modulation rates. Inthis example, user 138 indicates whether the tones are the same ordifferent using a standard two-alternative forced choice method, as iscommonly known in the art. Diagnostic module 131 may generate temporalinformation indicative of an ability of user 138 to perceive whether thetones are the same or different.

In this example, diagnostic module 131 analyzes the temporal informationto determine whether user 138 exhibits auditory dysfunction in temporalperception. If diagnostic module 131 determines that user 138 exhibitsauditory dysfunction in temporal perception, diagnostic module 131configures rehabilitation program 107 to increase the temporalperception of user 138, e.g., by training user 138 to discriminatechanges in the depth or rate of envelope modulations near the limits oftheir discrimination thresholds that were individually determined bydiagnostic module 131.

In yet another example, diagnostic module 131 is configured to measuremonaural perception of user 138 by determining discrimination anddetection thresholds for user 138 in response to sounds deliveredindependently to each ear. In this example, diagnostic module 131 mayonly convey auditory stimuli to the right ear and then ask user 138 todetect with the right ear changes in pitch and/or tempo of an auditorysignal. Diagnostic module 131 records information indicative of anability of the user's right ear to correctly perceive changes in pitchand/or tempo of the auditory signal. Diagnostic module 131 may conveystimuli to the left ear only and ask user 138 to detect changes in pitchand/or tempo in the same auditory signal using the left ear. Diagnosticmodule 131 records information indicative of an ability of the user'sleft ear to correctly perceive changes in pitch and/or tempo of theauditory signal. Based on the ability of user 138 to correctly perceivethe auditory signal with either ear, diagnostic module 131 generatesseparate profiles the detection and discrimination thresholds for eachear for user 138.

In another example, diagnostic module 131 tests binaural perception ofuser 138 by varying the temporal properties or amplitude properties ofthe sound delivered to each ear of user 138. In an example, user 138 ispresented with sinusoidal tones embedded in identical background maskingnoise to each ear. In normal listeners, the ability to detect thepresence of the tone amidst the background noise depends upon theirability to perceive differences between the phase of the sinusoidaltones presented to each ear. When the phase of the tones presented toeach ear are inverted, sensitivity to the tones is maximized. When thetones are in phase, there is decreased benefit in sensitivity comparedto presenting the tone to one ear alone. Accordingly, this technique maydetermine the ability of user 138 to recognize tones with variable phasedifferences embedded in noisy backgrounds. In this example, diagnosticmodule 131 generates binaural information based on the sensitivity ofuser 138 to interaural phase cues.

In this example, diagnostic module 131 analyzes the interaural phasesensitivity functions to determine whether user 138 exhibits a deficitin their ability to integrate signals presented to each earsimultaneously. If diagnostic module 131 determines that user 138exhibits auditory dysfunction in binaural perception, diagnostic module131 configures rehabilitation program 107 to train user 138 to utilizeinteraural phase differences near threshold values determined indiagnostic module 131.

In still another example, diagnostic module 131 measures signal-to-noiseperception of user 138. In this example, diagnostic module 131 playsbackground noise. Diagnostic module 131 also instructs user 138 toperform an action when user 138 detects an auditory signal (e.g., atone) in the background noise. Based on the ability of user 138 tocorrectly perceive the auditory signal amidst the background noise,diagnostic module 131 generates signal-to-noise information indicativeof a strength of the signal-to-noise perception of user 138. Thisinformation can in-turn be used to generate rehabilitation program 107.

In another example, diagnostic module 131 measures signal-to-noiseperception of user 138 based on speech intelligibility, in which user138 is instructed by diagnostic module 131 to repeat monosyllabic words(e.g., from the CID W-22 word list used in audiology clinics) into amicrophone. Diagnostic module 131 presents a word to user 138 at twodifferent signal levels, including, e.g., at 10 dB and 30 dB above theminimal audible threshold defined from the audiogram under two differentsignal-to-noise conditions (e.g., a condition of no noise, a conditionof babbling speech noise with a root mean square (“RMS”) amplitude thatis 5 dB below the decibel level of spoken words, and so forth). In thisexample, diagnostic module 131 generates signal-to-noise information byanalyzing the ability of user 138 to correctly perceive the presentedword at the different signal levels and at the different signal-to-noiseconditions.

In this example, diagnostic module 131 analyzes the signal-to-noiseinformation to determine whether user 138 exhibits auditory dysfunctionin signal-to-noise perception. If diagnostic module 131 determines thatuser 138 exhibits auditory dysfunction in signal-to-noise perception,diagnostic module 131 configures rehabilitation program 107 to trainuser 138 to perceive signal-to-noise ratios at the threshold limitdefined by diagnostic module 131.

In an example, following diagnosis of the amount of auditory dysfunctionin user 138, diagnostic module 131 generates rehabilitation program 107to improve the auditory perception of user 138 through the engagement ofneural plasticity mechanisms. In this example, diagnostic module 131generates rehabilitation program 107 by generating instructionsspecifying the types of acoustic cues to be included in auditorystimulus 132 and the range of values that may be used for the acousticcues in auditory stimulus 132.

In an example, application 104 generates numerous challenge levels forrehabilitation program 107. Application 104 may change the challengelevel of rehabilitation program 107 based on a proficiency of user 138in locating virtual target 118. In this example, as user 138 becomesmore proficient in locating virtual target 118, application 104increases a difficulty of rehabilitation program 107 by adjusting thechallenge level to a more difficult level of play. A level of playbecomes more difficult by reducing an amount of time in which user 138may locate virtual target 118. The level of play may also become moredifficult by compressing the range of values for the acoustic cues(e.g., making the cues more similar to one another). The level of playmay also become more difficult by making the target area (e.g., virtualtarget 118) smaller.

In another example, application 104 generates a score indicative of anability of user 138 to locate virtual target 118 in rehabilitationprogram 107. In this example, the score is at least partly based onnumerous factors, including, e.g., an amount of time required for user138 to locate virtual target 118, the challenge level of rehabilitationprogram 107 when user 138 locates virtual target 118, and so forth.

In an example, application provider device 140 is configured to trackand to store scores of other users of other rehabilitation programsgenerated by application provider device 140 and/or by otherapplications downloaded from application provider device 140. In thisexample, application 104 may display for user 138 information indicativeof the scores of the other users, e.g., to promote competition amonguser 138 and the other users and/or to incentivize user 138 to beat thescores of the other users.

In still another example, rehabilitation program 107 may be used by user138 over multiple consecutive training sessions spanning several days toseveral months. In yet another example, user 138 may spend a variableamount of time using rehabilitation program 107, including, e.g.,fifteen minutes per day, thirty minutes per day, sixty minutes per day,and so forth. Application 104 may also be configured to trackperformance on past sessions of play of rehabilitation program 107 andto adjust the difficulty level of rehabilitation program 107 accordinglyat the start of a new training session of rehabilitation program 107.

In an example, application 104 may be configured to display arehabilitation program (not shown) that uses distributed targets, inwhich target locations are reflected in the outline of shapes that aretraced by user 138. In this example, the rehabilitation program includesa closed-loop auditory tracing task, e.g., which is implemented inreal-time by application 104. For example, in user 138, low-level areasof the auditory cortex feature an over-representation of soundfrequencies bordering the hearing loss and a disorganized representationof sound frequencies in the deafferented zone of the tonotopic map. Inthis example, the closed-loop auditory tracing task differentiates thetonotopic representation within the expanded zone and reformats thedisorganized region such that the region features an orderlyrepresentation of residual hearing frequencies, thereby improvingtinnitus and/or decreasing an about of auditory dysfunction (e.g.,hearing loss).

Through the closed-loop auditory tracing task, users are trained to makefine discrimination of sound frequencies surrounding the hearing loss(i.e., the signal) while suppressing the tinnitus percept (i.e., thenoise). That is, the tone frequencies are associated with the leveland/or with the type of hearing loss experienced by user 138.Additionally, the noise is indicative of an amount of tinnitusexperienced by user 138. Referring to FIG. 1B, user 138 is trained tomake a fine discrimination of sound frequencies surrounding the hearingloss, while suppressing the tinnitus percept, by having user 138 tracethe outline of invisible polygon 150, e.g., guided only by real timeauditory feedback. The sound that user 138 hears at any instant isdefined by the properties of the center pixel occupied by a finger ofuser 138 or a pointer used by user 138, in addition to the ongoingnoise, which is generated by diagnostic module 131.

In the example of FIG. 1B, region 151 surrounding polygon 150 isrepresentative of the noise, including, e.g., spectrally filtered speechbabble that masks the tinnitus percept. Polygon 150 is represented by arange of tone frequencies bordering the hearing loss. As describedabove, the tone frequencies may be selected to improve a type of hearingloss experienced by user 138. In this example, application 104 alertsuser 138, when user 138 is tracing at the top of the outline ofinvisible polygon 150, by rendering a tonal stimulus. Application 104alerts user 138 to the fact that user 138 is straying further from theoutline, as the tone becomes weaker, e.g., leaving only the ongoingnoise used to mask the tinnitus percept.

The tones associated with the outline change, in real-time, to include arange of frequencies to differentiate and to reformat the abnormalregions of the brain (i.e., near where the hearing loss occurs). Inanother example, the change in frequencies along the outline could varyrandomly or be made to signal a particular event (e.g., an increase or adecrease in frequency could signal an upcoming shift in the outlinecontour to the right or to left, respectively).

In the example of FIG. 1B, various portions of polygon 150 are displayedin various colors. In this example, each color is indicative of aparticular tone frequency in the above-described range of tonefrequencies. As user 138 traces the various portions of polygon 150,which are initially hidden, the various portions of polygon 150 aredisplayed in display 108 in accordance with the various colorsassociated with the various portions.

Referring to FIG. 1C, application 104 encourages the involvement ofpredictive/working memory systems of user 138 by cueing user 138 to thesemantic category to which the polygon belongs (e.g., simple shapes,sports equipment, famous monuments) and by leaving fading vapor trail152 of the outline that user 138 has recently traced, which wouldprovide some information to user 138 about which portion of polygon 150user 138 should trace next. In this example, fading vapor trail 152displays portions of polygon that user 138 has correctly traced andidentified. In another example, application 104 is configured to brieflyflash on display 108 the target shape (e.g., polygon 150) before thetrial begins so that user 138 has a higher-order representation of whatto trace. In this example, fading vapor trail 152 displays variouscolors that correspond to the above-described range of tone frequenciesfor the portions of polygon included in fading vapor trail 152.

Referring to FIG. 1D, at the end of a trial (e.g., at the completion ofthe rehabilitation program), user 138 is shown diagram 154, whichrepresents the disparity between the path traced by user 138 and thetarget shape e.g., polygon 150. In this example, diagram 154 may alsodisplay information specifying a completion time in which user 138identified polygon 150 and an overlap score. Generally, an overlap scoreincludes information indicative of a percentage of overlap between theoutline of polygon 150 and the outline that user 138 traced. In anexample, where application 104 is implemented as a multi-player game,diagram 154 may also display information showing completion time forother users and overlap scores for the other users.

Referring to FIG. 1E, another polygon 156 is presented to user 138. Inthis example, polygon 156 is associated with increased difficulty oftracing, e.g., relative to the difficulty of tracing polygon 150.Additionally, the tracing of polygon 156 may be made more difficult byadjusting various attributes of application 104, including, e.g., givinguser 138 less time to “solve” the problem (e.g. less time to tracepolygon 156), increasing the falloff slope such that user 138 gets lesswarning when user 138 is straying from the outline of polygon 156,making the frequency changes that signal a change in the contourorientation of polygon 156 more subtle, and making the shapes morecomplicated (e.g., as shown by polygon 156).

FIG. 2 is a block diagram of system 100 for promotion of auditoryrehabilitation. In FIG. 2, references numbers 106-108, 110, 112, 114,116, 118, 120, 122, 124, 126, 130, 132, 134 are not shown.

In the illustrated example of FIG. 2, computing device 102 can receiveinformation from application provider device 140 via input/output(“I/O”) interface 200 over network 139. I/O interface 200 can be anytype of interface capable of receiving information over a network, suchas an Ethernet interface, a wireless networking interface, a fiber-opticnetworking interface, a modem, and so forth. Computing device 102 alsoincludes a processing device 202 and memory 204. A bus system 206,including, for example, an information bus and a motherboard, can beused to establish and to control information communication between thecomponents of computing device 102.

Processing device 202 may include one or more microprocessors.Generally, processing device 202 may include any appropriate processorand/or logic that is capable of receiving and storing information, andof communicating over a network (not shown). Memory 204 can include ahard drive and a random access memory storage device, such as a dynamicrandom access memory, or other types of non-transitory machine-readablestorage devices. As shown in FIG. 2, memory 204 stores computer programsthat are executable by processing device 202. These computer programsinclude application 104, tracking engine 105, and diagnostic module 131.

FIG. 3 is a flow diagram of exemplary process 300 for diagnosing typesof auditory dysfunction. In operation, diagnostic module 131 determines(302) one or more types of auditory perception in which user 138exhibits auditory dysfunction. As previously described, user 138 mayexhibit auditory dysfunction in spectral perception, temporalperception, binaural perception, signal-to-noise perception, and soforth. Additionally, diagnostic module 131 is configured to diagnoseauditory dysfunction using the techniques described herein.

Using the diagnosed types of auditory dysfunction, diagnostic module 131generates (304) an acoustic cue. As described in further detail withregard to FIG. 4, this acoustic cue is included in auditory stimulus 132for promotion of auditory rehabilitation in the type of auditorydysfunction. That is, diagnostic module 131 is configured to diagnosetypes of auditory dysfunction and generate auditory cues based on thediagnosis. Promotion of auditory rehabilitation is performed throughrehabilitation program 107, as described in further detail in FIG. 4.

Following generation of an acoustic cue, diagnostic module 131determines (306) a range of values for the acoustic cue. The range ofvalues may be based on an amount and/or severity of auditory dysfunctionidentified by diagnostic module 131. In an example, diagnostic module131 determines that user 138 exhibits a loss of sensitivity to aparticular range of frequencies. In this example, for the acoustic cueto promote rehabilitation of sound level perception in user 138,diagnostic module 131 determines the range of values to be 50 db-70 db.In another example, diagnostic module 131 determines that user 138exhibits a severe amount of auditory dysfunction in pitchdiscrimination. In this example, for the acoustic cue to promoterehabilitation of pitch perception in user 138, diagnostic module 131determines the range of values to be 1-2 octaves, thereby increasing therange values when user 138 exhibits severe auditory dysfunction inspectral perception relative to the range of values when user 138exhibits moderate auditory dysfunction.

In the illustrative example of FIG. 3, diagnostic module 131 determines(308) if there are additional types of auditory dysfunction for whichacoustic cues should be generated. That is, an acoustic cue is generatedfor each type of auditory dysfunction diagnosed in action 302.Accordingly, actions 304, 306, 308 are repeated for each type ofauditory dysfunction. If diagnostic module 131 determines that there areadditional types of auditory dysfunction for which acoustic cues shouldbe generated, diagnostic module 131 repeats actions 304, 306, 308, untildiagnostic module 131 determines that there are no additional types ofauditory dysfunction for which acoustic cues should be generated.

When diagnostic module 131 determines that there are no additional typesof auditory dysfunction for which acoustic cues should be generated,diagnostic module 131 generates (310) instructions that include theacoustic cues and the range of values for the acoustic cues. In anexample, application 104 uses the instructions in generating auditorystimulus 132, e.g., by generating auditory stimulus 132 that blendstogether the various acoustic cues with values for the acoustic cuesthat are within the range of values. In a variation of FIG. 3,diagnostic module 131 determines the type of auditory dysfunction, theacoustic cues, and the range of values for the acoustic cues.

FIG. 4 is a flow diagram of exemplary process 400 for promotion ofauditory rehabilitation. In operation, application 104 starts (402)rehabilitation program 107, e.g., by causing graphical user interface106 to be displayed on display 108 of computing device 102. Aspreviously described, following display of graphical user interface 106at time T1, user 138 moves avatar 110 via input device 136 in an effortto locate virtual target 118.

As user 138 moves avatar 110 in graphical user interface 106, computingdevice 102 regenerates response information 134 that includesinformation indicative of a location of avatar 110 in graphical userinterface 106. Computing device 102 sends response information 134 toapplication 104. Tracking engine 105 receives (404) response information134. Using response information 134, tracking engine 105 updates (notshown) the location of avatar 110 on map 130. Tracking engine 105 alsodetermines (406) the location of avatar 110 on map 130 relative to thelocation of virtual target 118 on map 130. Tracking engine 105determines (408) whether the location of avatar 110 on map 130 matchesthe location of virtual target 118 on map 130.

In the illustrative example of FIG. 3, when tracking engine 105determines that the location of avatar 110 on map 130 matches thelocation of virtual target 118 on map 130, tracking engine 105 generates(410) a message congratulating user 138 on locating virtual target 118.The message may include visual representation 116 displayed in graphicaluser interface 114, as illustrated in FIG. 1A. When tracking engine 105determines that the location of avatar 110 on map 130 does not match thelocation of virtual target 118 on map 130, tracking engine 105determines (412) whether the location of avatar 110 on map 130 indicatesthat avatar 110 has moved towards or away from virtual target 118, e.g.,relative to a prior location of avatar 110 in map 130.

Using the determination of whether avatar 110 has moved towards or awayfrom virtual target 118, application 104 generates (414) auditorystimulus 132. In an example, application 104 generates auditory stimulus132 automatically and in real-time to promote an efficient and real-timeauditory rehabilitation feedback loop. As previously described, auditorystimulus 132 may include numerous acoustic cues. The acoustic cuesgenerated by diagnostic module 131 promote auditory rehabilitation inthe areas of auditory perception that diagnostic module 131 identifiedas exhibiting auditory dysfunction.

In the illustrative example of FIG. 4, application 104 generatesauditory stimulus 132 by using response information 134 to select anupdated value from the range of values for an acoustic cue. Aspreviously described, based on the types of auditory dysfunction,diagnostic module 131 determines a range of values for an acoustic cue.Within the range of values, application 104 may adjust the acoustic cuesto train user 138 to perceive changes in properties of auditory stimulus132 and thereby locate virtual target 118.

In an example, diagnostic module 131 determines that user 138 exhibitssevere auditory dysfunction in the perception of soft sounds at aparticular range of frequencies. To promote auditory rehabilitation inspectral perception, diagnostic module 131 determines that acoustic cuesfor spectral perception include tones ranging from 2000-8000 Hz, e.g.,as illustrated in the above Table 1. In this example, tones ranging from2000-8000 Hz are determined to be most effective in training individualsto detect properties of an audio signal that will enhance theirperception of soft stimuli. Within the identified range of values,application 104 selects and/or determines a value for the acoustic cuebased on the proximity of avatar 110 to virtual target 118. In thisexample, as avatar 110 moves towards virtual target 110, application 104increases the decibel level of the acoustic cue towards the 60 dB valueof the range. As avatar 110 moves away from virtual target 118,application 104 decreases the decibel level of the acoustic cue towardsthe 80 dB value of the range.

Computing device 102 plays (416) for user 138 auditory stimulus 132,e.g., via headphones 137. In response to hearing auditory stimulus 132,user 138 further moves avatar 110 in graphical user interface 106 in adirection that user 138 perceives as moving avatar 110 towards virtualtarget 118. Computing device 102 translates the movement of avatar 110into response information 134 and the foregoing actions 404, 406, 408,412, 414, 416 continue until user 138 locates virtual target 118 ingraphical user interface 114. In this illustrative example of FIG. 4,application 104 implements an auditory rehabilitation feedback loop(e.g., a closed loop) through execution of actions 404, 406, 408, 412,414.

Described herein is a system that promotes auditory rehabilitation in anindividual with auditory dysfunction. The system is configured todiagnose auditory dysfunction in various types of auditory perception.Based on the type of diagnosed auditory dysfunction, the system isfurther configured to generate a rehabilitation program that promotesauditory rehabilitation by challenging the individual to locate avirtual target that is hidden in a virtual environment of therehabilitation program.

To assist the individual in locating the virtual target, therehabilitation program provides the individual with acoustic cuesindicative of a proximity of an avatar in the virtual environment to thevirtual target. In an example, the system generates an acoustic cue thatpromotes auditory rehabilitation for one or more of the types ofdiagnosed auditory dysfunction. By listening to, and learning from, theacoustic cues during play of the rehabilitation program, the systemengages adaptive brain plasticity mechanisms of the individual (e.g.,relative to the neural plasticity of the individual prior to playing therehabilitation program). Based on the increase in neural plasticity, theindividual may experience an improvement in hearing.

Embodiments can be implemented in digital electronic circuitry, or incomputer hardware, firmware, software, or in combinations thereof.Apparatus of the invention can be implemented in a computer programproduct tangibly embodied or stored in a machine-readable storage devicefor execution by a programmable processor; and method actions can beperformed by a programmable processor executing a program ofinstructions to perform functions of the invention by operating on inputinformation and generating output. The invention can be implementedadvantageously in one or more computer programs that are executable on aprogrammable system including at least one programmable processorcoupled to receive information and instructions from, and to transmitinformation and instructions to, a information storage system, at leastone input device, and at least one output device. Each computer programcan be implemented in a high-level procedural or object orientedprogramming language, or in assembly or machine language if desired; andin any case, the language can be a compiled or interpreted language.

Suitable processors include, by way of example, both general and specialpurpose microprocessors. Generally, a processor will receiveinstructions and information from a read-only memory and/or a randomaccess memory. Generally, a computer will include one or more massstorage devices for storing information files; such devices includemagnetic disks, such as internal hard disks and removable disks;magneto-optical disks; and optical disks. Storage devices suitable fortangibly embodying computer program instructions and information includeall forms of non-volatile memory, including by way of examplesemiconductor memory devices, such as EPROM, EEPROM, and flash memorydevices; magnetic disks such as internal hard disks and removable disks;magneto-optical disks; and CD ROM disks. Any of the foregoing can besupplemented by, or incorporated in, ASICs (application-specificintegrated circuits).

Other embodiments are within the scope and spirit of the descriptionclaims. For example, due to the nature of software, functions describedabove can be implemented using software, hardware, firmware, hardwiring,or combinations of any of these. Features implementing functions mayalso be physically located at various positions, including beingdistributed such that portions of functions are implemented at differentphysical locations.

What is claimed is:
 1. A method performed by one or more processingdevices, the method comprising: starting a program; generating data fora graphical user interface that when rendered on a display of a displaydevice renders a visual representation of an object; identifying anauditory stimulus signal indicative of a location of a virtual target inthe graphical user interface; receiving data representing a location ofthe visual representation of the object in the graphical user interface;intermittently determining whether a location of the visualrepresentation of the object in the graphical user interface correspondsto the location of the virtual target until the location of the visualrepresentation of the object in the graphical user interface correspondsto the location of the virtual target; while the location of the visualrepresentation of the object in the graphical user interface does notcorrespond to the location of the virtual target, determining, based onprocessing of the data representing the location of the visualrepresentation of the object, a proximity of the visual representationof the object to the virtual target in the graphical user interface;intermittently modifying, based on the proximity, the auditory stimulussignal by modifying a frequency of the auditory stimulus signal, asignal-to-noise ratio of the auditory stimulus signal, a sound level ofthe auditory stimulus signal, a binaural characteristic of the auditorystimulus signal, or a modulation of a sound envelope of the auditorystimulus signal; and causing one or more speaker devices to play themodified auditory stimulus signal; when the location of the visualrepresentation of the object in the graphical user interface correspondsto the location of the virtual target, completing the program.
 2. Themethod of claim 1, further comprising: detecting, following play of theauditory stimulus, that a location of the visual representation of theobject in the graphical user interface corresponds to the location ofthe virtual target in the graphical user interface.
 3. The method ofclaim 1, wherein the actions of receiving, determining, andintermittently modifying are repeated until a location of the visualrepresentation of the object in the graphical user interface correspondsto the location of the virtual target in the graphical user interface.4. The method of claim 1, further comprising: causing a diagnosticauditory signal to be played on the one or more speaker devices;receiving information indicative of a response of a user to thediagnostic auditory signal; determining, at least partly based on thereceived information, auditory dysfunction in one or more types ofauditory perception of the user; determining, based on the determinedauditory dysfunction, the frequency; and determining, based on one ormore amounts of auditory dysfunction in the one or more types ofauditory perception, one or more ranges of values for the frequency. 5.The method of claim 4, wherein the one or more ranges of values compriseone or more ranges of first values, and wherein the method furthercomprises: detecting a decrease in auditory dysfunction of the user; andupdating, based on the detected decrease, the first values to secondvalues, with the second values promoting an additional decrease inauditory dysfunction of the user.
 6. The method of claim 1, furthercomprising: determining, based on the proximity, that the visualrepresentation of the object has moved towards the virtual target; andgenerating a notification that the visual representation of the objecthas moved towards the virtual target.
 7. The method of claim 1, furthercomprising: determining, based on the proximity, that the visualrepresentation of the object has moved away from the virtual target; andgenerating a notification that the visual representation of the objecthas moved away from the virtual target.
 8. The method of claim 1,wherein the auditory stimulus promotes auditory rehabilitation in a userby training the user to locate the virtual target in the graphical userinterface based on a perception of the user of the frequency.
 9. One ormore machine-readable media configured to store instructions that areexecutable by one or more processing devices to perform operationscomprising: starting a program; generating data for a graphical userinterface that when rendered on a display of a display device renders avisual representation of an object; identifying an auditory stimulussignal indicative of a location of a virtual target in the graphicaluser interface; receiving data representing a location of the visualrepresentation of the object in the graphical user interface;intermittently determining whether a location of the visualrepresentation of the object in the graphical user interface correspondsto the location of the virtual target until the location of the visualrepresentation of the object in the graphical user interface correspondsto the location of the virtual target; while the location of the visualrepresentation of the object in the graphical user interface does notcorrespond to the location of the virtual target, determining, based onprocessing of the data representing the location of the visualrepresentation of the object, a proximity of the visual representationof the object to the virtual target in the graphical user interface;intermittently modifying, based on the proximity, the auditory stimulussignal by modifying a frequency of the auditory stimulus signal, asignal-to-noise ratio of the auditory stimulus signal, a sound level ofthe auditory stimulus signal, a binaural characteristic of the auditorystimulus signal, or a modulation of a sound envelope of the auditorystimulus signal; and causing one or more speaker devices to play themodified auditory stimulus signal; when the location of the visualrepresentation of the object in the graphical user interface correspondsto the location of the virtual target, completing the program.
 10. Theone or more machine-readable media of claim 9, wherein the operationsfurther comprise: detecting, following play of the auditory stimulus,that a location of the visual representation of the object in thegraphical user interface corresponds to the location of the virtualtarget in the graphical user interface.
 11. The one or moremachine-readable media of claim 9, wherein the actions of receiving,determining, and intermittently modifying are repeated until a locationof the visual representation of the object in the graphical userinterface corresponds to the location of the virtual target in thegraphical user interface.
 12. The one or more machine-readable media ofclaim 9, wherein the operations further comprise: causing a diagnosticauditory signal to be played on the one or more speaker devices;receiving information indicative of a response of a user to thediagnostic auditory signal; determining, at least partly based on thereceived information, auditory dysfunction in one or more types ofauditory perception of the user; determining, based on the determinedauditory dysfunction, the frequency; and determining, based on one ormore amounts of auditory dysfunction in the one or more types ofauditory perception, one or more ranges of values for the frequency. 13.The one or more machine-readable media of claim 12, wherein the one ormore ranges of values comprise one or more ranges of first values, andwherein the operations further comprise: detecting a decrease inauditory dysfunction of the user; and updating, based on the detecteddecrease, the first values to second values, with the second valuespromoting an additional decrease in auditory dysfunction of the user.14. The one or more machine-readable media of claim 9, wherein theoperations further comprise: determining, based on the proximity, thatthe visual representation of the object has moved towards the virtualtarget; and generating a notification that the visual representation ofthe object has moved towards the virtual target.
 15. The one or moremachine-readable media of claim 9, wherein the operations furthercomprise: determining, based on the proximity, that the visualrepresentation of the object has moved away from the virtual target; andgenerating a notification that the visual representation of the objecthas moved away from the virtual target.
 16. The one or moremachine-readable media of claim 9, wherein the auditory stimuluspromotes auditory rehabilitation in a user by training the user tolocate the virtual target in the graphical user interface based on aperception of the user of the frequency.
 17. A system comprising: one ormore processing devices; and one or more machine-readable mediaconfigured to store instructions that are executable by the one or moreprocessing devices to perform operations comprising: starting a program;generating data for a graphical user interface that when rendered on adisplay of a display device renders a visual representation of anobject; identifying an auditory stimulus signal indicative of a locationof a virtual target in the graphical user interface; receiving datarepresenting a location of the visual representation of the object inthe graphical user interface; intermittently determining whether alocation of the visual representation of the object in the graphicaluser interface corresponds to the location of the virtual target untilthe location of the visual representation of the object in the graphicaluser interface corresponds to the location of the virtual target; whilethe location of the visual representation of the object in the graphicaluser interface does not correspond to the location of the virtualtarget, determining, based on processing of the data representing thelocation of the visual representation of the object, a proximity of thevisual representation of the object to the virtual target in thegraphical user interface; intermittently modifying, based on theproximity, the auditory stimulus signal by modifying a frequency of theauditory stimulus signal, a signal-to-noise ratio of the auditorystimulus signal, a sound level of the auditory stimulus signal, abinaural characteristic of the auditory stimulus signal, or a modulationof a sound envelope of the auditory stimulus signal; and causing one ormore speaker devices to play the modified auditory stimulus signal; whenthe location of the visual representation of the object in the graphicaluser interface corresponds to the location of the virtual target,completing the program.
 18. The system of claim 17, wherein theoperations further comprise: detecting, following play of the auditorystimulus, that a location of the visual representation of the object inthe graphical user interface corresponds to the location of the virtualtarget in the graphical user interface.
 19. The system of claim 17,wherein the actions of receiving, determining, and intermittentlymodifying are repeated until a location of the visual representation ofthe object in the graphical user interface corresponds to the locationof the virtual target in the graphical user interface.
 20. The system ofclaim 17, wherein the operations further comprise: causing a diagnosticauditory signal to be played on the one or more speaker devices;receiving information indicative of a response of a user to thediagnostic auditory signal; determining, at least partly based on thereceived information, auditory dysfunction in one or more types ofauditory perception of the user; determining, based on the determinedauditory dysfunction, the frequency; and determining, based on one ormore amounts of auditory dysfunction in the one or more types ofauditory perception, one or more ranges of values for the frequency.